1. Incidence of sentinel lymph node metastases in apparent early-stage endometrial cancer: a multicenter observational study
- Author
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De Vitis, L, Fumagalli, D, Schivardi, G, Capasso, I, Grcevich, L, Multinu, F, Cucinella, G, Occhiali, T, Betella, I, Guillot, B, Pappalettera, G, Shahi, M, Fought, A, Mcgree, M, Reynolds, E, Colombo, N, Zanagnolo, V, Aletti, G, Langstraat, C, Mariani, A, Glaser, G, De Vitis, Luigi Antonio, Fumagalli, Diletta, Schivardi, Gabriella, Capasso, Ilaria, Grcevich, Leah, Multinu, Francesco, Cucinella, Giuseppe, Occhiali, Tommaso, Betella, Ilaria, Guillot, Benedetto E, Pappalettera, Giulia, Shahi, Maryam, Fought, Angela J, McGree, Michaela, Reynolds, Evelyn, Colombo, Nicoletta, Zanagnolo, Vanna, Aletti, Giovanni, Langstraat, Carrie, Mariani, Andrea, Glaser, Gretchen, De Vitis, L, Fumagalli, D, Schivardi, G, Capasso, I, Grcevich, L, Multinu, F, Cucinella, G, Occhiali, T, Betella, I, Guillot, B, Pappalettera, G, Shahi, M, Fought, A, Mcgree, M, Reynolds, E, Colombo, N, Zanagnolo, V, Aletti, G, Langstraat, C, Mariani, A, Glaser, G, De Vitis, Luigi Antonio, Fumagalli, Diletta, Schivardi, Gabriella, Capasso, Ilaria, Grcevich, Leah, Multinu, Francesco, Cucinella, Giuseppe, Occhiali, Tommaso, Betella, Ilaria, Guillot, Benedetto E, Pappalettera, Giulia, Shahi, Maryam, Fought, Angela J, McGree, Michaela, Reynolds, Evelyn, Colombo, Nicoletta, Zanagnolo, Vanna, Aletti, Giovanni, Langstraat, Carrie, Mariani, Andrea, and Glaser, Gretchen
- Abstract
Objective Ultrastaging is accurate in detecting nodal metastases, but increases costs and may not be necessary in certain low-risk subgroups. In this study we examined the risk of nodal involvement detected by sentinel lymph node (SLN) biopsy in a large population of apparent early-stage endometrial cancer and stratified by histopathologic characteristics. Furthermore, we aimed to identify a subgroup in which ultrastaging may be omitted. Methods We retrospectively included patients who underwent SLN (with bilateral mapping and no empty nodal packets on final pathology) +/- systematic lymphadenectomy for apparent early-stage endometrial cancer at two referral cancer centers. Lymph node status was determined by SLN only, regardless of non-SLN findings. The incidence of macrometastasis, micrometastasis, and isolated tumor cells (ITC) was measured in the overall population and after stratification by histotype (endometrioid vs serous), myometrial invasion (none, <50%, >= 50%), and grade (G1, G2, G3). Results Bilateral SLN mapping was accomplished in 1570 patients: 1359 endometrioid and 211 non-endometrioid, of which 117 were serous. The incidence of macrometastasis, micrometastasis, and ITC was 3.8%, 3.4%, and 4.8%, respectively. In patients with endometrioid histology (n=1359) there were 2.9% macrometastases, 3.2% micrometastases, and 5.3% ITC. No macro/micrometastases and only one ITC were found in a subset of 274 patients with low-grade (G1-G2) endometrioid endometrial cancer without myometrial invasion (all <1%). The incidence of micro/macrometastasis was higher, 2.8%, in 708 patients with low-grade endometrioid endometrial cancer invading <50% of the myometrium. In patients with serous histology (n=117), the incidence of macrometastases, micrometastasis, and ITC was 11.1%, 6.0%, and 1.7%, respectively. For serous carcinoma without myometrial invasion (n=36), two patients had micrometastases for an incidence of 5.6%. Conclusions Ultrastaging may be safel
- Published
- 2024